SEPTEMBER 2013 VOLUME 2 • ISSUE 3

Eastern Iowa Sleep Center – Football Players & OSA

“High school and college athletes sacrifice a lot to improve their game”, says Aaron Taylor, former offensive lineman for the Green Bay Packers and CPAP user. Per the American Academy of Sleep Medicine, young football players, especially offensive and defensive lineman, are at an increasingly high risk for Obstructive Sleep Apnea.” It’s critical to diagnose and treat OSA in young athletes as early as possible. For more information visit www.iowasleepcenter.com and view our Sleep Apnea video.

The Provider’s Corner

Safety, Shift Work combined with Sleep issues are a concern for many. Operators of heavy equipment, drivers, fire fighters, police officers, healthcare providers and staff or other safety sensitive professions should pay careful attention to signs of sleepiness.
Sleep problems and fatigue affect many of the nearly 15 million shift workers. The risk involved for workers and others around them if dozing off even for a brief moment (called a microsleep) could be detrimental in many ways. For the sleep-deprived, microsleeping can occur at any time, typically without substantial warning. People who experience microsleeps usually remain unaware of them, instead believing themselves to have been awake the whole time, or to have temporarily lost focus. For sleepiness at work here are some suggestions to stay alert: walk around when you can, talk to co-workers, schedule activities wisely around 4:00-5:00am when night shift workers hit their lowest energy period.

The National Sleep Foundation lists several strategies to help the shift worker including: maintain a consistent sleep-wake schedule, make the sleep environment as quiet as possible, and reduce or eliminate all light exposure. If your patient still has trouble falling asleep, staying asleep or feels excessively tired during their awake time, it may be time for sleep study.

Ask your patients if they are a shift worker to check if they are at risk.

Hot Topic: Sleep Study and PAP

Time lapse between Sleep Study (PSG) and PAP treatment is being addressed in the Medicare local coverage determinations regarding dispensing PAP equipment. The patient must have face-to-face clinical evaluation by the treating physician prior to the sleep test to assess the beneficiary for obstructive sleep apnea (must be a face to face encounter, cannot be done via a phone call or email). This documentation must be sent to the DME supplier before the patient is set up on PAP device.

In order to ensure a worry free transition for your patient from Sleep Study to PAP treatment: Patients that are 90 days from PSG can be set up with equipment without delay. Patients that wait until after 90 days to 1 year to acquire their PAP will first have to revisit with their provider before equipment can be dispensed. Specific provider documentation is needed: The equipment is still needed, there is no change in patient’s condition, why the delay in treatment between the PSG and starting the PAP device. All patients must meet coverage criteria. Patients that wait until after 1 year must have a new PSG or Split Night-basically they start all over.

Insurance networks

The Eastern Iowa Sleep Center is contracted with multiple insurance companies. Please contact your insurance carrier to know your benefits and coverage regarding a sleep study. EISC will assist when and where we can.

Bottom line: Encourage your patients to follow through with the Sleep Study and get the needed treatment prescribed as soon as possible to avoid delay and added costs.

What’s New: Direct Scheduling/ Pre Auth Form

EISC has improved its access to allow direct scheduling of patients from provider offices. Providers can speak to EISC staff and schedule the study while still with the patient if the need is urgent.

The referral still will need to be faxed as usual. If the patient requires a Pre-Authorization from the provider’s office the patient may be scheduled 12-15 days out to ensure approval is received. To ensure proper pre-authorization information for your patient a form has been created to assist provider offices. A copy has been sent with this edition. Please fax the pre-authorization form with your referral or fax it 24 hours prior to the patient’s sleep study. Working together we can reduce patient sleep study cancellations. If you have questions, please contact EISC. The Pre-Auth Form is also located at www.iowasleepcenter.com/forms/.

MEDICARE-SLEEP STUDY & PAP EQUIPMENT

Diagnostic or split night PSG 90 days old

Patient to be set up with equipment if they meet coverage criteria. Diagnostic or split night PSG 90 days-1 year old

Patient must have a new face to face evaluation with treating or referring physician documenting:

Equipment is still needed

There has been no change in patient’s condition

Why the delay in treatment between PSG and starting on PAP device

Patient meets coverage criteria

Diagnostic or split night PSG > 1 year old

Patient must have a new diagnostic or split night PSG

Patient meets coverage criteria

What’s Coming: Daylight Saving Ends

The first Sunday in November is coming soon! Clocks are set back 1 hour at 2:00am.
Did you know that not all the U.S. observes the daylight saving time change? In particular, Hawaii and most of Arizona do not use it. Prepare for this change in your sleep habits.

Access: Outreach

Regional Medical Center in Manchester continues to grow. As of May, EISC is there
3 nights a week and still may need to increase to meet the demand. Jones Regional Medical Center has also increased to 2 nights a week. Remember for a clean copy of the Outreach referral forms please visit www.iowasleepcenter.com/forms/.